When and how should I transfuse during obstetric hemorrhage?

J H Waters; M P Bonnet

doi:10.1016/j.ijoa.2021.102973

When and how should I transfuse during obstetric hemorrhage?

Int J Obstet Anesth. 2021 May:46:102973. doi: 10.1016/j.ijoa.2021.102973. Epub 2021 Mar 11.

Authors

J H Waters¹, M P Bonnet²

Affiliations

¹ Department of Anesthesiology & Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Mcgowan Institute for Regenerative Medicine, Pittsburgh, PA, USA. Electronic address: watejh@upmc.edu.
² Sorbonne University, Department of Anesthesia and Intensive Care, Armand Trousseau Hospital, DMU DREAM, GRC 29, AP-HP, Paris, France; Paris University, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetric Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France.

PMID: 33903001
DOI: 10.1016/j.ijoa.2021.102973

Abstract

The incidence of maternal hemorrhage and blood transfusion has increased over time. Causes of massive hemorrhage, defined as a transfusion > 10 units of erythrocytes, include abnormal placental insertion, preeclampsia, and placental abruption. Although ratio-based transfusion has been described for managing massive hemorrhage, a goal-directed approach using laboratory or point-of-care data may lead to better outcomes. Autotransfusion, which involves the collection, washing, and filtration of maternal shed blood, avoids many of the complications associated with allogeneic blood transfusion. In this review, we provide an overview of transfusion practices related to the management of obstetric hemorrhage.

Keywords: Hemorrhage; Obstetric; Point-of-care testing; Transfusion.

Publication types

Review

MeSH terms

Abruptio Placentae*
Blood Transfusion
Female
Humans
Incidence
Placenta
Postpartum Hemorrhage* / therapy
Pregnancy